HEENT: Bitemporal wasting. There is no icterus. The pupils are equal and reactive to light. . The oropharyngeal membranes are normal.

Lymphatic: There is no palpable lymphadenopathy.

Chest: The lungs are clear to auscultation and percussion.

Breast: Without masses.

Cardiovascular: There are no murmurs, gallops, or rubs. There is no lower extremity edema, warmth, tenderness, or erythema.

Gastrointestinal: The abdomen is somewhat firm. Bowel sounds are present. There are no definite masses. There is no evidence of ascites. There is no guarding or rebound. The liver is not palpable.

LABORATORY: On 09/16/2015, glucose was 118, BUN 18, creatine 0.62. Electrolytes were normal. Calcium 9.2 total, total protein 7.[_3:16___], albumin 3.0. Liver function studies were normal. White count 13,200, hematocrit 32.9, MCV 76.4, platelet count 794,000, differential normal. …show more content…
There were pockets of fluid collection in the left upper quadrant anterior to the left kidney and within the left lower pelvis. There was diffuse small bowel thickening, which has been reported in the past. There was soft tissue fullness in the upper abdomen, posterior to the left lobe of the liver with limited anatomic assessments appearing stable since the prior exam. Assessment for masses is difficult due to the lack of intra-abdominal fat. There was a large amount of stool was in the rectum. There was a diminution in the previous [4:42____] soft tissue densities involving the pleura, since the prior